Pneumonia, Hydrocarbon

Clinical Presentation:
Respiratory distress including grunting, cough, and fever after the
aspiration of hydrocarbons. Symptoms may develop in minutes or hours
depending on the volume aspirated.

Etiology/Pathophysiology:
The causative hydrocarbon agents are petroleum solvents, dry cleaning
fluid, lighter fluid, kerosene, gasoline, and liquid polishes and
waxes. Once aspirated, due to their low viscosity and surface
tension, they reach the dependent portion of the lung and cause a
chemical pneumonia. Pulmonary edema can develop rapidly. Long term
there can be loss of elastic recoil, and small airway obstruction,
which can lead to increased reactive airway disease and chronic lung
disease in adults.

Imaging Findings:
CXR changes can be seen between 6-24 hours after aspiration which
vary from punctate infiltrates to massive lung opacification and are
more common in the dependent portion of the lungs. Air trapping and
pleural effusions may also be seen. The CXR findings peak at 72 hours
after aspiration and persist up to 3-4 weeks. Pneumatoceles can be
seen during the healing phase due to airway necrosis complicated by
air trapping. The CXR does not correlate with clinical findings.

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